What is the importance of a dermoscopy to your
practice? How do you use your findings?
While I own a dermatoscope, as does my PA, I
rarely change my diagnosis based on dermoscopic
findings and would feel uncomfortable not biopsying
a nevus based on a dermoscopic evaluation of
a bona fide nevus. However, dermoscopic evaluation
often reassures me on seborrheic keratoses
(SK) and vascular lesions, so the tool is well worth
having.

Over the years I have attended numerous meetings
and presentations about this technology and
am pleased to see that the science is evolving.
Nonetheless, I look forward to the time when the
methodology is more predictable.

What kind of considerations or accommodations
should physicians make for the treatment of
patients who are deaf?According to Nebraska state rules, I must make
'reasonable' accommodations for a deaf patient.
This may mean many different things for different
patients. For example, if you have an unaccompanied
child who is deaf or one who has non-signing
parents or guardians, it may be entirely reasonable
to hire an interpreter. On the other hand, if the
patient is able to read and write, I frequently have
communicated via an interpreter.

Whatever the case, make sure that you know the
cost and hours to be charged for the interpreter
should you hire one. We routinely ask this question
and many times are shocked that the rates for the
interpreter can be higher than our office charges
that day! Despite this, if you are legally compelled
to provide an interpreter, you must do so. Consider
calling your state health department for any particular
rules. Additionally, if you practice near a hospital,
consider checking to see if a staffer there
who is able to sign is willing to assist for the
patient.

Lastly, remember the importance of not turning
away this deaf patient or refusing to make a sincere
attempt to assist him or her. A recent case in New
Jersey resulted in a $400,000 verdict against a
rheumatologist who refused to provide this type of
care, which puts a chilling cost on not knowing or
following the rules.

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About Practical Dermatology

Practical Dermatology is the monthly publication that provides coverage of medical care, cosmetic advancements, and practice management for clinicians in the field. With straight-forward, how-to advice from experts in various fields, we strive to enhance quality of care and improve the daily operation of dermatology practices.

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